Pseudo-pigmented choroidal schwannoma with extraocular extension in an elderly patient.

Purpose: To describe a rare case of clinically pigmented choroidal schwannoma with extraocular extension in an elderly patient.

Observations: We report a case of a 79-year-old Black male who presented with a clinically pigmented, juxtapapillary choroidal tumor with concern for extraocular extension on standardized ocular echography. The lesion was concerning for choroidal melanoma with extraocular extension.

Risk Factors for Fibrous Ingrowth in Eyes Requiring Primary Keratoplasty.

Purpose: The aim of this study was to define risks for corneal transplantation associated with fibrous ingrowth among first-time transplant recipients.

Methods: We performed a retrospective case-control study of patients with a histopathologic diagnosis of fibrous ingrowth between 2002 and 2019. Patients with fibrous ingrowth from a first corneal specimen were included.

Posterior Embryotoxon Revisited: An Immunohistologic Study.

Purpose: This series describes the immunopathologic features of posterior embryotoxon (PE) and demonstrates that it is not an anterior displaced Schwalbe's line as commonly described, but a peripheral corneal stromal nub variable in location with abnormal extracellular matrix.

Design: Case series.

Participants: Archived specimens from patients with PE.

A direct transcutaneous approach to infraorbital nerve biopsy.

Purpose: To describe a novel transcutaneous infraorbital nerve biopsy technique which can be performed to aid in the diagnosis of perineural invasion (PNI) of facial cutaneous squamous cell carcinoma (SCC).

Methods: A single-center retrospective chart review was performed. Patients diagnosed with SCC with PNI via an infraorbital nerve biopsy between February 2019 and February 2020 were included.

Metastatic Squamous Cell Carcinoma of the Tonsil Mimicking Choroidal Melanoma.

We describe a case of a 53-year-old man with a history of metastatic squamous cell carcinoma of the tonsil who presented with a large, dome-shaped, choroidal mass in the left eye with concern for extra-ocular extension. Standardized echography showed a choroidal mass with low-to-medium internal reflectivity, pockets of very low reflectivity, positive angle kappa, and 1+ vascularity that were concerning for primary choroidal melanoma. Biopsy of the lesion was consistent with metastatic squamous cell carcinoma of the tonsil rather than melanoma.

Solitary adult orbital myofibroma: Report of a case and review of the literature.

Purpose: Myofibromas are benign soft tissue tumors commonly encountered in infancy and childhood. Developing usually within the first two years of life, they can be multicentric and involve deep visceral organs.

Observations: We present the rare occurrence of a solitary orbital myofibroma in an adult patient.

Primary ductal adenocarcinoma of the lacrimal gland: A review and report of five cases.

Primary ductal adenocarcinoma (PDA) is a rare epithelial tumor of the lacrimal gland. Herein we report 5 cases and review 29 published cases of PDA of the lacrimal gland. Among these 5 cases, the most common clinical presentation was painless swelling and/or proptosis of their eye.

Histochemical Analysis of Glaucoma Caused by a Myocilin Mutation in a Human Donor Eye.

Objective: Mutations in myocilin ( may cause either juvenile open angle glaucoma (JOAG) or adult-onset primary open angle glaucoma (POAG). encodes a glycoprotein that is normally secreted from trabecular meshwork cells that regulate intraocular pressure. Prior transgenic rodent, and organ culture experiments have suggested that abnormal accumulation of MYOC protein within trabecular meshwork cells is a key step in glaucoma pathophysiology.

Urinary β2-microglobulin and disease activity in patients with tubulointerstitial nephritis and uveitis syndrome.

Background: Urinary β2-microglobulin (Uβ2M) is elevated in tubulointerstitial nephritis and uveitis (TINU) syndrome and has emerged as an important diagnostic tool. This study aims to determine whether Uβ2M correlates with uveitis activity in TINU.

Methods: Retrospective observational case series of nine patients with TINU and ≥ 30 days follow-up.

Orbital implant exposure after Acanthamoeba panophthalmitis.

Purpose: Acanthamoeba is a protozoa that can lead to severe ocular disease and sequelae. Although intraocular Acanthamoeba infection is rare, the following case demonstrates an unusual presentation of recurrent Acanthamoeba infection in a 30 year old contact lens wearing male.

Observations: After presenting with recurrent Acanthamoeba keratitis and undergoing various treatments, the patient developed nodular scleritis, which evolved into panophthalmitis, and ultimately, required enucleation.

Identification of Herpes Zoster-Associated Temporal Arteritis Among Cases of Giant Cell Arteritis.

Purpose: To examine whether herpes zoster antigen (also called varicella-zoster virus antigen) was detectable in temporal artery biopsies taken from individuals with giant cell arteritis (GCA).

Design: Retrospective comparative case series.

Methods: Sections of formalin-fixed paraffin-embedded temporal arteries were examined first by hematoxylin-eosin (H&E) staining to establish the diagnosis of GCA.

Immunopathology and histopathology of conjunctival biopsies in patients with presumed idiopathic punctal stenosis.

Background/aims: Numerous processes have been implicated as causes of punctal stenosis. Recent studies have highlighted inflammation in punctoplasty specimens in patients with punctal stenosis. Conjunctival biopsy has been suggested as a means to determine underlying aetiologies, although little is known regarding what conjunctival pathologies are associated with punctal stenosis.

Ketamine/Xylazine-Induced Corneal Damage in Mice.

Purpose: We have observed that the commonly used ketamine/xylazine anesthesia mix can induce a focally severe and permanent corneal opacity. The purpose of this study was to establish the clinical and histological features of this deleterious side effect, its sensitivity with respect to age and anesthesia protocol, and approaches for avoiding it.

Methods: Young C57BL/6J, C57BLKS/J, and SJL/J mice were treated with permutations of anesthesia protocols and compared using slit-lamp exams, optical coherence tomography, histologic analyses, and telemetric measurements of body temperature.

Optic Nerve Sheath Fenestration: Current Preferences in Surgical Approach and Biopsy.

Purpose: Optic nerve sheath fenestration (ONSF) has evolved since its inception in 1872. Surgical approaches include a lateral orbitotomy, a medial orbitotomy, or a superomedial lid crease. The actual fenestration can be done with slits or a window excision with biopsy.

Examining and processing eye specimens.

This chapter provides basic and useful information about handling and processing eye specimens as well as diagnosing common diseases encountered by ophthalmic pathologists. Each section is devoted to a specific part of the eye (cornea, conjunctiva, iris and cilliary body, choroid, retina, vitreous, and the optic nerve), providing useful pearls about the basic anatomy, disease processes, special staining, and tissue processing.

Choroidal schwannoma in a 6-month-old girl.

Choroidal schwannomas are exceedingly rare in children, with only 6 cases reported in children younger than 18 years of age and none in those younger than 9 years. We report a 6-month-old infant presenting with a large noncalcified amelanotic mass with secondary glaucoma that mimicked an atypical retinoblastoma, leading to emergent enucleation for therapeutic and diagnostic purposes. Pathology revealed a total retinal detachment, glaucomatous damage, and a large mass arising from the peripapillary posterior choroid with areas of Antoni A pattern and S-100 staining consistent with the diagnosis of an intraocular schwannoma.

Keloidal scarring in hard palate grafts.

Hard palate grafts are a commonly accepted treatment for lower eyelid retraction and are typically associated with low complication rates. The authors present a case of bilateral keloidal scarring within hard palate grafts requiring surgical excision. A 72-year-old woman who had undergone bilateral hard palate grafts to her lower eyelids for lower eyelid retraction was referred for the evaluation of ocular irritation.

Uveitis following intravitreal bevacizumab: a non-infectious cluster.

Background And Objective: In this retrospective case series, the authors report seven cases of bevacizumab-related uveitis that occurred within a 4-month period.

Patients And Methods: Seven eyes of six patients developed non-infectious uveitis following bevacizumab intravitreal injections in a cohort of 978 consecutive bevacizumab injections.

Results: The mean age of patients was 74.

Diffuse anterior retinoblastoma without retinal involvement.

Purpose: To present a unique case of an 8.5-year-old child with unilateral, anterior, pseudouveitis. He was found to have unilateral, invasive, small blue cell tumor of the anterior segment that was diagnosed as diffuse infiltrating retinoblastoma despite lack of retinal involvement on fundus examination or histopathologic analysis.